Family

The Long-Haul Breastfeeders of COVID

Desperate for a little extra pandemic protection, some women are nursing their kids much later than they ever imagined they would.

A woman breastfeeding a toddler.
Nicola Katie/iStock/Getty Images Plus

Robin Zanak’s son was born at the end of June 2020. It was a few months into the pandemic, and so she’d had time to process what it might mean to have a baby during the COVID era. She wanted to breastfeed but intended to offer herself a little grace if it didn’t go entirely smoothly, especially after an early stomach obstruction landed her son in the NICU. But Zanak worked from home in Maryland—she was finishing a Ph.D. and now teaches communications classes part time at a college—and so it was easy to take little 10 minute breaks here and there to breastfeed. She rarely had to nurse in public and never had to switch to majority-pumping. Now, Zanak says, “My son is 17 months old, and I can’t believe I’m still nursing.”

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There was another factor for Zanak, too. When her son was 9 or 10 months old, around the time she’d imagined beginning the process of weaning him, she was able to finally get the COVID-19 vaccine. She knew that one of the benefits of breastfeeding is that—at least early on in a baby’s life—the child is able to acquire some “passive” immunity to diseases from its mom, via an antibody substance present in the mother’s milk. Zanak did a little research into whether her son might get COVID protection, too, from her milk once she got the vaccine.

Zanak learned the science wasn’t yet conclusive on whether her son was getting much protection. But, she says, “This is the one defense he has at this point. He can’t wear a mask. He can’t get vaxxed.” She’s planning, at this point, to keep feeding until around the time he turns 2 in June 2022, which she’s hoping will coincide with him being able to get his own vaccine. (Pfizer has said it expects to submit an application for its under-5 vaccines in “the first half” of 2022.)

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Zanak isn’t alone in extending her breastfeeding timeline as a result of the pandemic—at least among the relatively affluent, largely white women who tend to dominate a lot of the public discourse around breastfeeding in the United States. (Guilty: I am breastfeeding a 6-month-old, and I fit roughly into that description.) This year, I started to hear about more friends and friends of friends who were going a lot longer than the six months or one year of breastfeeding they might have aimed for before the pandemic, based on the American Academy of Pediatrics’ recommendations about breastfeeding.

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Among the women I spoke to about their pandemic feeding habits, going eighteen months or two years was relatively common. I also heard about some women breastfeeding 4-year-olds, though none of them wanted to talk to me. Perhaps because there’s stigma around extended breastfeeding that goes that long. One woman, breastfeeding a large-for-her-age 2-year old, told me her husband wants her to stop. “He’s like, enough already. He thinks it starts to get weird at 18 months. He’s like, OK dude, who is this for?” The New York Times even reported earlier this year on mothers who’d weaned their children but then attempted the biologically difficult process of relactation after they got their vaccine.

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Some researchers’ preliminary data about breastfeeding during the pandemic indicates that extended lactation among this set could be a real trend—one that might have lasting consequences for gender norms and class disparities. (Not to mention that it might increase the potential for guilt and shame experienced by parents who, for any number of excellent reasons, formula-feed.) One not-yet-published survey conducted from March to June of 2020 and shared with me by a group of researchers at Washington University in St. Louis, Johns Hopkins, and the University of North Carolina looked at how the pandemic was affecting breastfeeding decisions. That sample, which was disproportionally white and upper-middle-class, showed that more than 30 percent wanted to extend breastfeeding until the end of the pandemic, and a high proportion were able to do it during the early lockdowns. Many cited the immunological protection afforded by mother’s milk as the reason, along with the ease that working at home brought to breastfeeding. “[Working from home because of the pandemic] acted as a de facto paid leave for people who had an intention to breastfeed,” said Aunchalee Palmquist, a UNC medical anthropologist who worked on the survey.

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Jessica Calarco, a sociologist at Indiana University, began tracking a cohort of women through pregnancy and beyond in 2018 and 2019, so those children were between 6 months and 18 months when the pandemic hit. Her data showed that a quarter of those women were still breastfeeding at 18 months, and that at a year, nearly 10 percent more of the women in her study were breastfeeding than the national average for the previous year might have predicted—though she cautions that her sample has more stay-at-home and part-time parents than is nationally representative. (And she warns that we won’t have truly good data on any of this until the Center for Disease Control and Prevention’s Breastfeeding Report Cards come out in 2022 and 2023, which will include the data for pandemic babies.)

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The science is inconclusive on exactly what kind of COVID protection extended  breastfeeding provides. Multiple studies have shown that COVID antibodies are present in the breast milk of vaccinated mothers, which is good news. More recent research (still in preprint) also shows that T-cells in breast milk change after mRNA vaccination, which could mean additional immunity, aka even more good news. But as yet, there’s not much data on how much COVID protection is actually being absorbed by babies; that’s the next round of research. It seems likely that whatever immunity is conferred only lasts as long as breastfeeding is ongoing and is proportionate with the amount of the milk consumed by the baby. In other words, it wouldn’t function like a vaccine but more like a daily dose of medication, as the NYT explained. It might be that the protection is only mucosal, which is to say it would only come via the surfaces (like the throat, mouth, and nose) that the milk coats. But that’s not nothing, given the nature of COVID.

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For extended breastfeeding, though, there’s an additional open question of how much immunity is absorbed by older babies and toddlers. There’s not much good data, in general, on this question, since that older breastfeeding group hasn’t been much studied. Certain changes that happen in babies’ physiognomy (like more stomach acid) as they grow suggest that they’re never able to absorb every bit of immune protection that’s in breast milk as effectively as they do in the earliest days. The introduction of other food and drink—which usually happens by 6 months—also alters the ability of the antibodies to bind to cells. (One small Spanish study, cited last year by the American Academy of Pediatrics, did show that vaccinated mothers breastfeeding children beyond 23 months seemed to have the highest concentration of COVID antibodies of the women studied.) Still, a lot of the women I talked to said even a slim chance of protection was worth it.

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And looking for antibodies isn’t the only reason parents are breastfeeding longer during the pandemic. For a lot of office workers with young children, even if they’re working full time, in certain ways their lives now have the flexibility of the  stay-at-home and part-time-working mothers who statistically tend to breastfeed longer.

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Emily Mitchell Marell, an academic adviser who moved from Brooklyn to Woodstock, New York, during the pandemic, says she was the “last man standing” when her now-6-year-old stopped nursing at age 2. “I felt like a freak about it,” she says. “In music class a few years ago, I wouldn’t have wanted to nurse.” This time around, as she breastfeeds her 2 year old (born on March 14, 2020, the day before school closed in New York City) with no end date in sight, Marell has company. Of the five or six “mom friends” she’s acquired in Woodstock, all of whom have children between ages 1 and 3, all are nursing.  For her, it’s not about antibodies; it’s about access. “I’m always around. She can ask at any time, and I never had to pump so my supply is sky-high,” she says. “I could nurse on a call and no one would care. It’s more acceptable now if your kid is in the background.”

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Meghan Haire Gaffney works for a tech company in the Bay Area; she just weaned her 1-year-old, but for the last six months was exclusively pumping. (Anyone who has even partially pumped can tell you that this is a major commitment.) She says she wouldn’t have gone as long if it wasn’t for COVID. She wanted her daughter to get as many antibodies as possible, but also, she was no longer traveling for work. “It sounds terrible to be in a hotel room and have to ship your breast milk,” she says.

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There are also fewer life events to plan around now, too. Sara Petry, a CPA who lives in Lutherville, Maryland, plans to keep nursing her 1½-year-old until the COVID vaccine is available to him. She had weaned her other children around 1, and when he turned 1, in May 2021, she imagined she might wean him, too. Vaccines were more widely available, and infections were decreasing. She had a bachelorette party to attend in August, and she set that as the deadline to end breastfeeding. But then delta hit, and child hospitalizations went up. “Instead of weaning him, I backed out of the bach,” she said. “They chose Florida. I was like, you guys are crazy.”

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While parents in certain urban enclaves might be seeking out vaccinated milk, the extended-breastfeeding-for-COVID-protection trend is not the national norm. A sizable group of parents—including a bunch of college-educated and vaccinated ones—believe that it’s not worth vaccinating very young children, since they’re not hit as hard by the disease. And, in preliminary data from a new survey Calarco is conducting, more than 60 percent of U.S. parents think that COVID-19 vaccines are either as dangerous or more dangerous for kids than the disease itself. (E.A. Quinn, a biological anthropologist at Washington University in St. Louis who also worked on the spring 2020 breastfeeding survey, told me that in one Missouri milk-sharing group a graduate student of hers was monitoring until recently, participants noted their vaccination status when they offered up milk. Unvaccinated milk was preferred; some people even went as far as to try to give back milk when they realized they got a vaccinated batch.)

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For other groups, barriers to breastfeeding were either worsened or created by the pandemic. Women farther down the income ladder and those in communities of color are less likely to have cultural support for breastfeeding, paid time off, or a clean place to pump, even if their job gives them enough break time to pump. In the earliest days of the pandemic, many women in Palmquist and Quinn’s 2020 survey feared that breastfeeding might actually put their baby at risk if they were to contract the virus and decided that formula would be safer. (We now know that kind of transmission doesn’t happen, but Palmquist told me that women who were at high risk of contracting COVID, like doctors and nurses, went so far as to live in an apartment separate from their babies, pump, and send milk home.)

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Calarco says that in her study, the women who were more likely to stop breastfeeding earlier than they wanted were parents who went back to work outside the home during COVID, including health care workers. And even for those who didn’t, not everyone appreciated the extra breastfeeding time. For some women, the extra physical contact was a stressor, another way to be pulled in multiple directions simultaneously while trapped indoors; COVID actually led them to wean. One mom in the study described her toddler daughter climbing up on her lap and trying to nurse during the workday.

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Calarco wonders whether social pressure for extended breastfeeding, if it exists as the pandemic drags on, would have a chilling effect on women’s decisions to return to in-person work, if they have the financial freedom to stay home. She pointed out that Americans’ preference for “traditional” gender roles has increased during the pandemic. (Anecdotally, two of the women I spoke to for this story had recently become stay-at-home moms, at least temporarily.) “Especially if the moms in the position to take advantage of extended breastfeeding are affluent white moms leading the trend, it has downstream consequences and can lead to shaming of women who can’t make that choice,” says Calarco.

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Alyssa Lindsey, an educator in Baltimore County, Maryland, is still breastfeeding her 3½-year-old. This is her third child, and the others were weaned around a year old. She had already gone a little longer than she’d expected but was thinking she’d wean when her daughter turned 2. That happened in May 2020, at the height of the pandemic’s first wave. “Maybe it’ll help protect her,” she thought. She wasn’t vaccinated—no one was—but “no one knows anything but it’s not NOT going to help,” she told herself. “So why not?”

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In February 2021, she was vaccinated; in April, her daughter (along with her other two children) got COVID. But Lindsey still thinks maybe the reason her toddler was totally asymptomatic had something to do with whatever protection she was getting from breast milk. I asked her if she’s setting vaccine availability as a deadline for weaning. She said no. “People are weird about it,” she said. Because of COVID, she admitted, “ I could be like, I want her to have the antibodies. Even though that wasn’t the reason. The real reason was I like it, and it’s working for us.”

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